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University of Groningen Physically active learning Wijnsma, Marijke IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2017 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Wijnsma, M. (2017). Physically active learning: the effect of physically active math and language lessons on children’s academic achievement. Rijksuniversiteit Groningen. Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 24-01-2021

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Page 1: University of Groningen Physically active learning Wijnsma ... · 54 Chapter 4 Physically active academic lessons improve academic achievement ABSTRACT Objectives Using physical activity

University of Groningen

Physically active learningWijnsma, Marijke

IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.

Document VersionPublisher's PDF, also known as Version of record

Publication date:2017

Link to publication in University of Groningen/UMCG research database

Citation for published version (APA):Wijnsma, M. (2017). Physically active learning: the effect of physically active math and language lessonson children’s academic achievement. Rijksuniversiteit Groningen.

CopyrightOther than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of theauthor(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).

Take-down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.

Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.

Download date: 24-01-2021

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Pediatrics 2016; 137(3): DOI: 10.1542/peds.2015-2743

Physically active math and language lessons improve

academic achievement: a cluster RCT

Marijke J. Mullender-WijnsmaEsther Hartman

Johannes W. de GreeffSimone Doolaard

Roel J. BoskerChris Visscher

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Physically active academic lessons improve academic achievementChapter 4

ABSTRACT

Objectives Using physical activity in the teaching of academic lessons is a new way of learning. The aim of this study was to investigate the effects of an innovative physically active academic intervention (Fit & Vaardig op school [F&V]) on academic achievement of children.

Methods Using physical activity to teach math and spelling lessons was studied in a cluster-randomized controlled trial. Participants were 499 children (mean age 8.1 years) from second- and third-grade classes of 12 elementary schools. At each school, a second- and third-grade class were randomly assigned to the intervention or control group. The intervention group participated in F&V lessons for 2 years, 22 weeks per year, 3 times a week. The control group participated in regular classroom lessons. Children’s academic achievement was measured before the intervention started and after the first and second intervention years. Academic achievement was measured by 2 mathematics tests (speed and general math skills) and 2 language tests (reading and spelling).

Results After 2 years, multilevel analysis showed that children in the intervention group had significantly greater gains in mathematics speed test (p < 0.001; ES = 0.51), general mathematics (p < 0.001; ES = 0.42) and spelling scores (p < 0.001; ES = 0.45). This equates to 4 months more learning gains in comparison with the control group. No differences were found on the reading test.

Conclusions Physically active academic lessons significantly improved mathematics and spelling performance of elementary school children and are therefore a promising new way of teaching.

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INTRODUCTION

The development of new ways of teaching and learning to foster children’s academic achievement is an important issue in educational sciences. Recently, programs have been developed that incorporate physical activity into the teaching of academic lesson content.1-7 The majority of the studies focused on short-term, immediate effects, and showed that children’s academic engagement,1,4,5 academic motivation,6 and executive functioning7 were enhanced shortly after physically active academic lessons. Effects of prolonged intervention periods are largely unknown. A 4-month intervention that integrated physical activity into academic lessons positively influenced the fluid intelligence of children, but no effects were found on language arts, math and science.8 In another study positive effects of the 3-year Physical Activity Across the Curriculum project (PAAC) were found on academic achievement: math, reading, and spelling scores improved.2,3 Although it was an elegant study, the aim of PAAC was not to improve academic achievement, but to promote physical activity and reduce obesity rates. PAAC coupled academic areas including math, history, geography, language, science, and health with moderate to vigorous physical activity for 90 minutes per week. Because math and language skills play a key role in children’s educational career and are of great importance for their social and occupational functioning in daily life,9 physical activity should specifically be incorporated when teaching math and language to optimally improve those skills. We recently developed ‘Fit & Vaardig op school’ (Fit and Academically Proficient at School ; F&V), a new series of lessons in which physical exercise is specifically used when teaching math and language in Dutch elementary schools. An initial 1-year pilot study to improve the program supported the feasibility of the intervention and indicated that F&V lessons may positively affect reading and math outcomes.10

The F&V intervention is designed to increase academic achievement. During F&V lessons and traditional classroom lessons, similar academic goals are pursued. The difference is that the goals are achieved by different ways of teaching and learning.10 Integrating physical exercise into visual and auditory academic lesson content may have several benefits. First, sensorimotor information obtained by the body (for example, through physical activity) appears to be an effective aid to learning during childhood.11 Second, it has been found that moderate to vigorous physical activity that immediately increases activity in the brain may enhance attention,12,13 and this might cause enhanced academic engagement after physically active academic lessons.4,5,14 Because academic engagement is a key predictor of academic achievement,15 it seems likely that more time on task during regular lessons (after a physically

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Physically active academic lessons improve academic achievementChapter 4

active academic lesson) might improve academic achievement in the long term. Furthermore, a longer period of regular moderate to vigorous physical activity might cause the brain to change morphologically (develop new cells and blood vessels) and functionally (affect brain cognitive performance).12,16 A study with 7- to 9-year-old children found functional changes to the brain occurred in children who participated in a 9-month afterschool physical activity program: the children showed improved brain indices of executive control.17

Building on the results of the initial 1-year F&V pilot study,10 we designed a 2-year cluster-randomized controlled trial to further investigate the effects of the F&V program on the reading, spelling and math performance of children. We expected that the intervention would improve children’s academic achievement. Because the main focus of the F&V lessons was on math and language, we specifically expected math and language skills to be improved by the intervention.

METHODS

Participants

The study was conducted within 5 elementary school boards in the northern Netherlands (46 schools). To be included, schools were required to be mainstream schools and only second- and third-grade classes were eligible to participate. Twelve of the 46 schools agreed to participate. At each school a second- and third-grade class were randomly assigned to the intervention (n = 249) or the control group (n = 250). Randomization was performed by the Netherlands Central Plan Bureau for Economic Policy. School principals, teachers, parents, children and researchers were unaware of upcoming assignment. At schools where the second-grade class had been assigned to the intervention, the third-grade class served as control, and vice versa. Written informed consent was obtained from the school principals of the participating schools. The parents/legal guardians were informed before the start of the intervention and were given the option to withdraw their permission for their child to participate at any time. All procedures were approved by the ethics committee of the Center for Human Movement Sciences of the University Medical Center Groningen/University of Groningen.

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Sample size determination

Based on findings from the PAAC study,2,3 an effect size of 0.44 was assumed (J.E. Donnelly and J.L. Greene, personal communication). The power analysis resulted in a total sample of ≥ 20 classes, with 25 children per class (power 0.8, 1-tailed, α = 0.05).18

Intervention

We developed a manual of physically active math and language lessons (F&V lessons). The difficulty of the teaching material was based on the math and language curriculum of second- and third-grade classes in the Netherlands. The lessons were aimed at young school children because these children were found to be more affected by classroom-based physical activity interventions than older children.19 The intervention lessons were taught in the classroom during 2 school years, 22 weeks per year, 3 times a week for 20–30 minutes. In each lesson, 10–15 minutes were spent on math activities and 10–15 minutes on language activities. The main focus was on constant practice and repetition. For example, the children jumped on the spot eight times to solve the multiplication sum “2x4”. Each lesson was supported by a presentation on the interactive whiteboard. The physical exercises were aimed at moderate to vigorous intensity.10

Measures

Academic achievement was measured by 2 language tests (reading and spelling) and 2 math tests (speed and general math skills). Children’s (technical) reading ability was determined using the One-Minute test, which entails the children reading aloud as many words as possible within a minute; this is then repeated with a different set of words. The total number of words read correctly determines the score (from 0 to 232). Test-retest reliability (r = 0.89 to 0.92) and construct validity (r = 0.78 to 0.86) of the One-Minute test for reading are good.20

The Speed-Test-Arithmetic assesses math speed performance. The children have to solve problems as quickly as possible. The test contains 5 rows of arithmetic sums. The children had to compute as many sums as possible per row within 1 min. The score is calculated as the total number of tasks solved: the maximum score is 200. Standardization was done on a sample of 4804 elementary schoolchildren from 54 schools in the Netherlands.21

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In addition, the ability scores on spelling and math were retrieved from a child academic monitoring system (CAMS). This standardized and norm-referenced test battery is administered twice a year by the majority of the elementary schools in the Netherlands. The spelling test has 2 parts. During the first part, the teacher reads out a sentence and repeats a certain word from it; the children then have to write that word correctly. The second part consists of individually identifying misspelled words. The reliability (r = 0.90 to 0.93), construct and content validity of the spelling test were good.22 The math test is an individual task that involves number sense, arithmetic, algebra, geometry, time and money, and knowledge of ratios and fractions. In second- and third-grades the test sets great store on solving arithmetic problems; from fourth grade onwards the attention shifts to algebra and knowledge of ratios and fractions.23 The reliability (r = 0.93 to 0.96) and construct and content validity of the math test were good.24

Procedure

Children’s academic achievement was measured before the start of the intervention (T0) at the end of the previous school year (CAMS) and at the beginning of the new school year (One-Minute test and Speed-Test-Arithmetic), after the first intervention year (8 months to 1 year after T0 [T1]), and after the second intervention year (1 year after T1 [T2]). Test administrators were trained to familiarize them with the One-Minute test and the Speed-Test-Arithmetic. These pre-tests were individually administered at the schools within 3 weeks. The test administration in the intervention and control groups was done under the same conditions. After the first and second intervention year, the children were posttested in a similar way as the pretesting.

In both intervention years the intervention group participated in the F&V lessons for 22 weeks, whereas the control group received the regular sedentary classroom lessons. The total instruction time was the same in the intervention and control groups. Six qualified elementary school teachers were hired to teach the F&V lessons in the first year. A 1-day training program was provided before the start of the intervention. The teachers learned to work with the lesson material and gave a trial lesson on a school that was not participating in the study. In the second year the lessons were taught by the regular classroom teachers, all teachers had undergone 1 day of training beforehand. At the start, halfway through, and at the end of the intervention they received coaching in the classroom. Blinding of children and teachers to group assignment was not possible as the intervention included physically active academic lessons.

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Statistical analyses

The descriptive statistics were calculated using the Statistical Package for the Social Sciences (version 22.0), with significance level set at 0.05. Baseline differences between intervention and control group were examined by using an independent t-test or a Chi-Square Test.

To take account of the variability between schools, we used repeated measures multilevel modeling (MLwiN 2.29) to analyze the effects of the intervention on academic achievement. Multilevel models were calculated for each academic achievement posttest, with time (T0, T1, T2) as level 1 U, children as level 2 U, and schools as level 3 U. Explanatory variables for the score on each academic achievement test included grade, gender and time (model 1). To assess the effect of the intervention on academic achievement, we used condition (intervention or control) and the interaction between condition and time as predictors (model 2). To account for multiple testing, we used a Bonferroni correction, resulting in a significance level of 0.0063. Effect sizes (ESs) were calculated as (estimated intervention effect) /√(variance at student level).25 Interpretation of ES was done to determine the learning gains of the intervention group compared with the control group. First, to determine the academic progress that the children would normally make in a school year (12 months, during which children attend school for about 10 months), the academic progress of the children in the control group in the second intervention year (from T1–T2) was calculated as (estimated score T2 - estimated score T1) /√(variance at student level). Second, by dividing ES by (academic progress of the control group) and by multiplying this by 10 (months of education per year), the number of months learning gains of the intervention group after two intervention years was obtained.

RESULTS

Figure 4.1 shows that of the initial 499 children (mean age = 8.1 ± 0.7 years) of 12 elementary schools, 249 children were assigned to the intervention and 250 children to the control group. Two schools dropped out in the second intervention year: 1 because of long-term absence of the teacher and the other because it was closed down. At T0, 466 to 488 children were measured, at T1, 453 to 475 children, and at T2 341 to 352 children. Common reasons for not completing the tests were absence from school or leaving to attend another school.

The number of boys was similar in the control and intervention groups. However, the children in the control group were significantly older than the children in the intervention group (t = -2.2, p = 0.03), as significantly more children in the control group were in third-grade

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(χ2 = 5.2, p = 0.02) (Table 4.1). Table 4.2 presents the mean scores of children who took the academic achievement tests per measurement moment.

The results of the multilevel analysis can be found in Table 4.3. At T0, only the math CAMS score of the intervention group was significantly lower than that of the control group (t = -2.77; p = 0.005) (model 2). The results further revealed no significant effect of the intervention on reading scores after 1 year (t = 0.00; p = 1.00; ES = 0.00, 95% confidence interval (CI): -0.10 to 0.10) or after two years (t = 0.76; p = 0.45; ES = 0.05, 95% CI: -0.06 to 0.17) (Figure 4.2A). The results of the spelling test revealed no significant effect after one intervention year (t = 1.57; p = 0.12; ES = 0.15, 95% CI: -0.04 to 0.33). However, after the

Figure 4.1 Flow of schools and students from enrollment, allocation, and analysis.

T0 T1 T2 T0 T1 T2 243 232 181 Reading 242 238 170 235 221 180 Spelling CAMS 232 229 167 245 232 181 Math speed 243 238 171 234 222 179 Math CAMS 232 228 162

Second and third grade classes of 12 elementary schools (n = 499 children)

Cluster randomization

12 classes allocated to intervention group (n = 249 children)

12 classes allocated to control group

(n = 250 children)

Anal

ysis

A

lloca

tion

En

rollm

ent

Assessed for eligibility (n = 46 schools)

Not interested in participation (n = 34 schools)

Lost in second year (n = 2 schools, n = 43

children) Year

2 Lost in second year

(n = 2 schools, n = 50 children)

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4second year there was a significant effect of the intervention on the spelling scores (t = 4.32; p < 0.001; ES = 0.45, 95% CI: 0.25 to 0.66) (Figure 4.2B). This equates to 4 months (0.45/1.08 x 10 = 4.17) more learning gains after 2 intervention years in comparison with the control group. In the math speed test, the children in the intervention group showed no significant improvement after 1 intervention year (t = 2.44; p = 0.02; ES = 0.20, 95% CI: 0.04 to 0.37), but after the second year they showed significantly greater improvement in comparison with the control group (t = 5.44; p < 0.001; ES = 0.51, 95% CI: 0.32 to 0.69) (Figure 4.2C).

This equates to > 4 months (0.51/1.12 x 10 = 4.55) more learning gains after 2 intervention years in comparison with the control group. Lastly, the results of the math CAMS test revealed that the scores of the children in the intervention group had improved significantly more than those of the control group after 1 year (t = 6.27; p < 0.001; ES = 0.53, 95% CI: 0.36 to 0.69) and also after two years (t = 4.49; p < 0.001; ES = 0.42, 95% CI: 0.23 to 0.60). The

Table 4.1 Pretest characteristics, by condition

  Control (n = 250) F&V (n = 249) p-value

Mean age, years (SD) 8.2 (.74) 8.0 (.72) 0.026a

Gender, n boys (%) 110 (22) 116 (23) 0.562b

Second-grade, n (%) 116 (23) 141 (28) 0.022b

a Independent t-test.b Chi-square test.

Table 4.2 Mean scores on academic achievement tests with (SD); n

   T0 T1* T2**

Reading Intervention group 80.73 (29.95); 243 102.62 (28.89); 232 125.34 (26.01); 181Control group 80.81 (31.29); 242 103.45 (29.05); 238 124.82 (30.93); 170

Spelling CAMS Intervention group 117.85 (7.40); 235 126.86 (7.90); 221 135.12 (8.72); 180Control group 118.84 (7.98); 232 127.16 (9.09); 229 133.49 (9.07); 167

Math speed Intervention group 38.82 (17.49); 245 60.44 (22.51); 232 83.81 (28.16); 181Control group 42.05 (18.70); 243 61.01 (23.53); 238 78.35 (26.59); 171

Math CAMS Intervention group 48.03 (19.16); 234 69.58 (16.78); 222 82.36 (15.85); 179Control group 53.94 (18.14); 232 68.65 (17.63); 228 82.83 (16.68); 162

* The children in the intervention group who were not retained in the study did not differ from the children in the control group who were not retained in the study (age, grade, gender, condition and pretest scores).** Of the children who were not retained in the study at the math CAMS test, there were significantly fewer third- grade children in the intervention group in comparison with the control group (χ2 = 5.31, p = 0.02). No other differences were found between the children in the intervention group who were not retained in the study and the children in de control group who were not retained in the study (age, grade, gender, condition and pretest scores).

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Physically active academic lessons improve academic achievementChapter 4

Tabl

e 4.

3 M

ulti

leve

l reg

ress

ion

coef

fici

ents

(B) a

nd S

tand

ard

Erro

r (S

E) fo

r ea

ch fa

ctor

pre

dict

ing

the

dom

ains

of

Aca

dem

ic A

chie

vem

ent

 Re

adin

gSp

ellin

g C

AMS

Mod

el 1

Mod

el 2

Mod

el 1

Mod

el 2

 B

SEp

BSE

pB

SEp

BSE

p

Fixe

d ef

fect

sRa

ndom

inte

rcep

t68

.156

1.91

866

.889

2.30

411

4.59

00.

587

114.

520

0.68

33rd

gra

dea

25.9

222.

280

< 0.

001*

26.1

942.

289

< 0.

001*

8.66

20.

575

< 0.

001*

8.76

70.

576

< 0.

001*

Boyb

0.31

92.

288

0.88

90.

251

2.28

60.

912

-1.2

650.

579

0.02

9-1

.284

0.57

70.

027

T1c

21.7

180.

655

< 0.

001*

21.7

150.

922

< 0.

001*

8.75

00.

275

< 0.

001*

8.32

70.

383

< 0.

001*

T2c

41.8

500.

731

< 0.

001*

41.1

571.

046

< 0.

001*

15.8

520.

304

< 0.

001*

14.5

120.

431

< 0.

001*

Inte

rven

tion

d2.

328

2.39

50.

332

0.05

50.

647

0.93

2In

terv

enti

on X

T1

0.00

51.

310

1.00

00.

852

0.54

40.

118

Inte

rven

tion

X T

21.

341

1.46

20.

360

2.59

00.

599

< 0.

001*

Rand

om e

ffec

tsVa

rian

ce s

choo

ls0.

000

0.00

01.

000

0.00

00.

000

1.00

01.

138

0.87

20.

193

1.13

90.

870

0.19

1Va

rian

ce s

tude

nts

604.

324

40.9

51<

0.00

1*60

2.68

540

.851

< 0.

001*

33.0

552.

604

< 0.

001*

32.9

392.

586

< 0.

001*

Vari

ance

tim

e99

.529

4.94

9<

0.00

1*99

.395

4.94

1<

0.00

1*16

.685

0.84

8<

0.00

1*16

.293

0.82

8<

0.00

1*D

evia

nce

1110

6.94

611

104.

552

8028

.608

8006

.816

Tabl

e 4.

3 co

ntin

ues

on n

ext p

age

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63

Physically active academic lessons im

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entC

hapter 4

4

Tabl

e 4.

3 Co

ntin

ued

 M

ath

spee

dM

ath

CAM

S

Mod

el 1

Mod

el 2

Mod

el 1

Mod

el 2

 B

SEp

BSE

pB

SEp

BSE

p

Fixe

d ef

fect

sRa

ndom

inte

rcep

t27

.565

1.68

128

.194

1.89

940

.589

1.38

242

.514

1.56

23rd

gra

dea

24.2

091.

531

< 0.

001*

24.4

251.

533

< 0.

001*

16.5

861.

242

< 0.

001*

16.6

151.

247

< 0.

001*

Boyb

3.37

91.

544

0.02

93.

332

1.53

80.

031

5.25

11.

251

< 0.

001*

5.20

11.

248

< 0.

001*

T1c

20.0

540.

665

< 0.

001*

18.4

550.

921

< 0.

001*

18.0

340.

542

< 0.

001*

14.7

400.

745

< 0.

001*

T2c

39.9

240.

741

< 0.

001*

35.8

761.

041

< 0.

001*

30.3

910.

601

< 0.

001*

27.7

120.

846

< 0.

001*

Inte

rven

tion

d-1

.445

1.68

80.

392

-3.8

011.

372

0.00

5*In

terv

enti

on X

T1

3.19

61.

308

0.01

56.

622

1.05

6<

0.00

1*In

terv

enti

on X

T2

7.91

21.

454

< 0.

001*

5.25

21.

171

< 0.

001*

Rand

om e

ffec

tsVa

rian

ce s

choo

ls13

.083

8.24

60.

113

12.7

398.

082

0.11

69.

174

5.65

70.

106

8.91

95.

545

0.10

9Va

rian

ce s

tude

nts

245.

041

18.5

03<

0.00

1*24

4.09

918

.353

< 0.

001*

158.

390

12.0

62<

0.00

1*15

9.07

912

.014

< 0.

001*

Vari

ance

tim

e10

3.23

65.

117

< 0.

001*

99.9

594.

954

< 0.

001*

64.4

143.

286

< 0.

001*

61.1

773.

121

< 0.

001*

Dev

ianc

e10

778.

213

1074

7.90

297

76.4

1397

34.8

80

a,b,

c,d Re

spec

tive

ly 2

nd g

rade

, gir

ls, T

0, a

nd c

ontr

ol g

roup

wer

e th

e re

fere

nce

cate

gori

es.

* Si

gnif

ican

t (p

< 0.

0062

5) re

gres

sion

coe

ffic

ient

.

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greatest improvement was after 1 year and there was a retention of this effect after 2 years (Figure 4.2D). After two intervention years, 4 months (0.42/1.03 x 10 = 4.08) more learning gains were made by the intervention group compared with the control group.

DISCUSSION

The results add to those from the PAAC study, in which various existing academic lessons were coupled with physical activity to promote physical activity: that study showed that physically active academic lessons improved children’s academic achievement.2,3 Our study goes beyond this finding by demonstrating that a new physically active series of lessons specifically aimed at improving math and language improves the math and language achievement of elementary schoolchildren. Because the school curriculum is comparable on most Dutch elementary schools, the findings of our study can be generalized to other Dutch elementary schools. Generalizing results to other economically developed countries seems warranted as similar findings were obtained in the PAAC study.

Figure 4.2 Predicted mean scores (based on the second model of the multilevel analysis) on the reading (A), spelling CAMS (B), math speed (C), and math CAMS (D) tests per measurement moment (T0, T1, T2).* Significantly greater improvement of the intervention group with the control group (p < 0.00625).

(A) Reading

(C) Math speed

(B) Spelling CAMS

(D) Math CAMS

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The F&V intervention improved performance on math and spelling but not on reading. This discrepancy might be caused by the content of the intervention program and the academic tests. The F&V program mainly focused on repetition of concepts that children had learned in earlier classes and memorization of these concepts. More concretely, the main focus was on solving arithmetic problems and the spelling of words and less on reading speed.10 The focus of the math speed test lies on solving arithmetic problems. In second-and third-grades the math CAMS test also focuses on solving arithmetic.23 The spelling CAMS measures children’s spelling level, and the reading test is about reading as many words as possible within a minute. This could mean that the intervention was particularly effective for improving the academic skills practiced during F&V lessons.

The effects of the intervention on academic achievement might be the result of a combination of mechanisms. One might be the effect of moderate to vigorous physical activity on the brain12,13,16,17 and on academic engagement.4,5,14 It is also possible that the innovative teaching method may be effective because brain and body work in conjunction and because our cognitive knowledge is rooted in bodily awareness.11,26 This would apply to children in particular, because all knowledge initially stems from sensory stimulation and motor processes.27 Further research with more than one intervention group and a control group is needed to find out why using physical exercise in teaching academic content is effective in improving children’s academic achievement.

In previous research it has been shown that children exercised at moderate to vigorous intensity for 64% of the duration of the F&V lessons.10 Extra physical activity during academic lessons may contribute positively to children’s overall health, prevent children from being overweight, and help in reaching the recommended 60 minutes of daily moderate to vigorous physical activity.2,28,29 Future research is needed to further investigate whether the lessons contribute to children’s health.

Some limitations to the findings should also be noted. First, enhanced academic performance after the first intervention year might be possible due to the presence of specially trained intervention teachers. This was obviated by training regular classroom teachers to teach the F&V lessons in de second year. Second, the CAMS was administered by the schools itself. Although this test administration is practice as usual, this could have influenced the results. Strengths of this study were the design (cluster-randomized controlled trial) and the large sample size. Furthermore, the novel contribution of this study is showing that specifically integrating physical activity into math and language lessons is sufficient to improve important academic skills.

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CONCLUSIONS

Participation in the F&V physically active math and language intervention positively contributed to math and spelling performance of elementary school children. After 2 intervention years, they gained 4 more months in spelling and math achievement compared with control children. The findings suggest that physically active academic lessons should be part of the school curriculum because it is an innovative and effective way for teachers to improve children’s academic achievement. Physical activity should specifically be integrated into math and language lessons in order to optimally improve those important skills.

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